Specialization: The Next Step for Chinese Medicine in the West

I just hung out with Rob Helmer. He’s practitioner of Chinese medicine based out of Toronto. He mentioned he’d written an article about the importance of specialization. I said to him, “Rob,” I said. “Could I post this on my blog?” And here we are.

Over the past thirty years, the practice of Chinese Medicine [CM] outside of China has been increasing by leaps and bounds! I’m sure those of you who have been in the profession for a while have witnessed this exciting progression.

Moreover, professional development opportunities and materials have had no choice but to follow the same pattern. For example, Chinese medical literature in Western languages including standardized translations of common CM terms have improved in quality and increased in number.

As well, the quality of education in CM schools has evolved from weekend courses to full-time programs of four years in length and doctorate programs. Ultimately, high quality post-graduate courses are becoming more accessible to today’s CM practitioner.

It is indeed fantastic that we have come so far.

The logical next question we may ask is, “What is the next step for CM in the West?”

Without a doubt, the short answer to this question is “specialization.” Unlike most other forms of alternative medicine, CM has a long history of specializations in various areas including traumatology, pediatrics, dermatology, and gynecology, just to name a few.

To date, however, the notion of specializing in one discipline within CM has yet to be widely accepted and embraced by practitioners in the Western world. Seven years ago, I chose to specialize in CM pediatrics and haven’t looked back. This article discusses both the why’s and how’s of becoming a CM specialist.

“It is much better to have one sharp knife than nine dull ones”

Originally, I chose to practice CM because I wanted to offer a form of medicine to the public that was effective in treating many different illnesses using several modalities. Much to my surprise, while studying in China for the first time, I discovered that most doctors are trained in a specialized branch of CM and use only one form of treatment with great expertise.

“It is much better to have one sharp knife than nine dull ones” is a poignant saying what one of my first CM teachers shared with me in response to my question “Why specialize?” Then the simple truth dawned on me…expertly using only one modality or treating only one group of diseases allows a Chinese medical practitioner to be better able to evaluate a potential patient and treat them quickly and effectively.

My Top Ten Benefits of Having a Chinese Medical Specialty…

The practitioner is better able to understand and treat a specific condition.

Patients improve faster which leads to more referrals.

The general public is more confident when under the care of a specialist and you gain better credibility from other health care providers.

Specializing allows you to attract the population of patients you truly enjoy treating.

Being unique allows you to separate yourself from others in your profession and you will actually receive referrals from other acupuncturists and herbalists.

Your target population increases in number because patients will travel from a distance to see you.

You become able to develop unique treatment approaches that will help further generations.

It’s easier to market yourself to the media and the general public.

Specializing allows you to focus your energy and time into one area of expertise; it also allows you to be more confident in your treatments and therefore under less stress.

Special knowledge is always more highly valued than general knowledge, which means you can charge what you are really worth for your time.

How do I become a specialist?

Good question! Below are what I consider to be the five most important steps in successfully making the transition from general practitioner to CM specialist.

a) Passion for the Subject – this is first on my list for a reason. You should choose a subject that you are passionate about. I love kids! Furthermore, helping children is a topic of interest that has always been close to my heart. As a result, when I decided to specialize, pediatrics was an easy and natural choice for me. Your decision to specialize in a particular area of CM is likely to be based on your personal experience and/or the influence of an inspiring teacher.

b) Logic – The yin side of passion is logic and together, these two entities create balance. It’s a wise decision to specialize in an area where modern medicine has experienced limited success. Logically, if you focus on the diseases that modern medicine treats effectively fewer patients will seek out alternative healthcare providers such as yourself. The manifestation of this basic logic has resulted in some of the pioneers of CM specialties.

Logic would also require you to specialize in treating a disease that taps into a large patient population. For example, 25% of people suffer from a skin problem making dermatology an excellent option for specialization.

Remember, from a patient’s perspective CM isn’t always the easiest course of treatment; so it is important to choose conditions which the sufferers are determined to seek help for. Infertility is a promising option because many patients are willing to spend the money and commit to the treatment if it will enhance their ability to conceive.

Fortunately, options for CM practitioners are virtually open when choosing a specialty because modern medicine has fallen short in the area of effectively treating modern medical (especially chronic) diseases.

c) Post-graduate studies: Find books, journal articles, or courses that discuss the subject you are interested in from a CM perspective. In addition, search or study the subject from a modern medical point of view so that you can discuss the disease(s) with other health professionals (who are possible referral sources).

A vast knowledge base will also come in handy when discussing with the patient past, present and future treatments options. It may also be wise to speak with other alternative medicine practitioners to find out if they treat these disorders and how effective the treatment is.

d) Clinical Practice with Various Specialists – For those of you seeking specialist training, the information gold mine can be found in China. But be forewarned… not all doctors in China are created equal and many are more interested in modern medicine rather than traditional Chinese medicine.

Another advantage of China is the vast number of patients a doctor can see on any given day resulting in the ability to more readily discover effective treatments. I recommend that you study with multiple specialists and from this experience, develop your own unique approach. Most importantly, this potpourri of clinical experience will instill your confidence in CM as being able to effectively treat the conditions you are choosing to specialize in.

e) Learn to Read Chinese – In modern medicine, doctors are responsible for reviewing current medical journals in order to keep their knowledge base up to date. The same principal applies for the informed practice Chinese medicine.

This means reading the medical journals written in China and other parts of Asia where CM is more widely accepted and there is extensive periodical literature and research. The good news – there are thousands of research articles written every year on each specialty. The bad news – these articles are written in Chinese.

Therefore, if you can’t read Chinese, you can’t tap into this plethora of information. Take it from someone who has learned to translate Chinese medical literature – it’s not has hard as you think and it does not take as long as you think. I took a night course on Basic Chinese for six months at the local university and independently studied the language an additional two hours per day.

After this time, I was able to translate my first CM article into English. This article took me two weeks to translate (in my spare time) and definitely needed editing. Dedicating the time to learning Chinese allowed me to instantly access useful information that had previously been unavailable.

The experience of translating my first article convinced me to begin working on another. My second article on the same subject took half the time to translate and every article since is progressively easier. Remember, choosing to specialize in a specific area of CM dramatically limits the number of characters you will need to learn.

For those of you interested in learning to read medical Chinese, there is a wide variety of resources available today that will take years off this once rigorous process. These resources include books, classes and computer programs.

I highly recommend Nigel Wiseman’s books and recently purchased the Wenlin program which is a computerized dictionary that makes translating much more efficient. Other translating programs are available that literally translate scanned articles for you, but you will need a sufficient language base in order to use these programs to avoid mistranslation.

Upon completing these five steps, you will need to develop promotional materials such as a website, written articles for relevant publications, and brochures to name a few. You may also want to become involved in organizations or support groups that assist the patient demographic you have chosen to serve.

Ultimately, choosing to specialize in CM pediatrics is the best career decision I have made.

By specializing in this particular area, I have experienced both professional and financial gains. My practice continues to grow every year and Blue Poppy Press has published my journal translations as well as my first book, Treatment of Pediatric Bed-wetting with Acupuncture and Chinese Medicine.

In addition to sharing the knowledge I have gained with others through written media, I have also began teaching post-graduate courses on the treatment of children with Chinese herbal medicine. Ultimately, my personal drive is based on one simple revelation… the knowledge that is gained today will affect the state of Chinese medicine tomorrow and for many years to come.

Rob Helmer lives and practices in Toronto and is the author of The Treatment of Pediatric Enuresis with Acupuncture and Chinese Medicine, from Blue Poppy Press. In it, you will find over 150 clinically implemented CM treatments proven to be effective. For more information visit his website www.roberthelmer.ca. Meet Rob at our Toronto clinic.

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I am an acupuncturist in Victoria BC, who is part of the growing social movement of Community Acupuncture. Our mandate is to offer high quality treatments, in a group setting at sliding scale rates ($15-40/treatment). Not only am I able to treat up to 5 people per hour, but by reducing the cost, I am now making my services available to a wider range of individuals- namely those on a limited budget.

I think the beauty of Chinese Medicine is that just like its practitioners, comes in all shapes and sizes. Specialization is also valuable in certain circumstances as it does hone your skills and increases your area of expertise. That being said, you run the danger of our profession being pigeon-holed by public perception. As mainstream as acupuncture has gotten, there is still a massive part of the population that is uninformed, if not out-right scared of the notion of someone inserting needles into their body. Then to tell someone that knows very little about acupuncture that you only treat “fertility” or “skin conditions” may in fact being doing our profession a disservice.

As a community acupuncturist, I enjoy the challenge of not knowing what comes walking in the door. I also feel that by welcoming more people and being open and willing to be flexible in what we treat, we ultimately will be reaching more people. I am very specialized as well, I have fine-tuned my skills so that I have the versatility to treat nearly any type of pain as well as a wide range of internal imbalances such as insomnia, menopause, migranes and more. And in that sense you could be practicing anything else as long as we remember that the effectiveness of what you do is very dependent on someone receiving enough frequency of treatment. If that isn’t there, it doesn’t matter what you practice, 1 treatment rarely does the trick. We are doing acupuncture, not hocus-pocus. The more people that receive acupuncture often enough, the greater our credibility and path to the mainstream.

I could elaborate on how I feel the going rates of acupuncture are also pigeon-holing practitioners into treating only individuals from upper classes, while leaving lower-middle classes completely under-served, but that is a battle for another day.

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